title: Evaluation of pedicled omental flap delivered through a minilaparotomy for immediate breast reconstruction in obese patients.
abstract: BACKGROUND
  Studies have shown the laparoscopically harvested omental flap to be a successful method for immediate breast reconstruction. However, data about its usefulness and safety in obese women are limited. This study examined the effectiveness and safety of a pedicled omental flap delivered via a minilaparotomy in women with a body mass index (BMI) higher than 30 kg/m(2).
  
  
  METHODS
  Women candidates for skin-sparing mastectomy underwent reconstruction with delivery of a pedicled omental flap via a minilaparotomy.
  
  
  RESULTS
  Surgery was performed for 24 women with a mean age of 57.54 years and a mean BMI of 32.54 kg/m(2). The operative time was prolonged by about 1 h without excess blood loss or prolongation of their hospital stay. Except for a single case of partial flap necrosis, no single total flap loss was recorded. In three patients (12.5 %), the flap volume was inadequate, and silicone implant was used as an adjunct. Only one patient (4 %) experienced a small incisional hernia. The majority of the patients (67 %) described their cosmetic outcome as excellent.
  
  
  CONCLUSIONS
  Delivery of a pedicled omental flap via a minilaparotomy is a safe and reliable method for immediate breast reconstruction after skin-sparing mastectomy in women with a BMI higher than 30 kg/m(2).
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Mansoura Oncology Center (OCMU), Mansoura faculty of medicine, Mansoura University, Gomhoria Street, Mansoura, 35511, Egypt, dr.ashrafkhater@yahoo.com.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Khater
mesh_terms: D015992:Body Mass Index; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D007813:Laparotomy / Q000379:methods*; D016462:Mammaplasty / Q000379:methods*; D015414:Mastectomy, Subcutaneous / Q000379:methods; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D009852:Omentum / Q000601:surgery / Q000637:transplantation*; D061214:Patient Safety; D012189:Retrospective Studies; D018570:Risk Assessment; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology